Metastatic Breast Cancer Alliance - Membership Application
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Welcome! Thank you for your interest in becoming involved with the MBC Alliance.

Our Vision

Transform and improve the lives of people living with metastatic breast cancer.

Our Mission

Unify the efforts of MBC Alliance members to improve the lives of, and outcomes for, those living with metastatic breast cancer and their families through increasing awareness and education about the disease and advancing policy and strategic coordination of research funding specifically focused on metastasis that has the potential to extend life, enhance quality of life and ultimately to cure.

Our Goals

Work together towards a time when:
- All MBC patients and their caregivers can access the care and services they need from a responsive and well-informed healthcare system
- MBC stakeholders - including those diagnosed and their families, health care providers, researchers, health policy influencers and policy makers - understand MBC and how it differs from early stage breast cancer
- MBC research focuses on extending life, enhancing quality of life and ultimately ending death from the disease
 
Membership Categories:
 
Organizations and individuals have the opportunity to join the Alliance as an:

1. Advocate: nonprofit organization or individual committed to the mission and vision of the Alliance and to pro-actively planning and executing initiatives including contributing necessary time and talent resources.

2. Supporter: nonprofit organization who endorses, promotes and generally supports Alliance activities in furtherance of its vision and mission.
 
3. Industry: Pharmaceutical and biotech companies committed to the mission and vision of the Alliance and to pro-actively planning and executing initiatives including contributing necessary time and talent resources as well as financial support.
 
NOTE: Individuals and nonprofit organizations are NOT required to make a financial commitment of any kind to join the Alliance. Activities of the Alliance that require funding are supported by the unrestricted financial contributions of the pharmaceutical and biotech members.
 
Responsibilities:
Depending on membership category, responsibilities include:

- Contributing to implementing and monitoring activities derived from the MBC Landscape Analysis
- Attending Alliance meetings via video conference and in person. Wherever possible, in-person meetings will coincide with other breast cancer conferences, e.g., SABCS, ASCO
- Sharing knowledge and information on research, lessons learned, success stories, case studies, program results and policy approaches to help accelerate actions to meet the needs of MBC patients
- Supporting Alliance activities, which can include direct and indirect funding for MBC initiatives, technical expertise, staff time, and assistance with social media and networking
- Actively participating on Alliance Task Force(s) and/or Advisory/Working Group(s) 

Criteria
Membership applications are reviewed based on the following:
1) Desire and willingness - as an organization or individual - to endorse, promote and support the values, general principles and activities of the Alliance as reflected in its vision, mission, and goals
2) Demonstrated engagement in cancer advocacy
3) Commitment to working collaboratively and cooperatively with other Alliance members
 
Required

I am/We are applying for membership as: 

A Nonprofit Organization - Advocate (see above)
A Nonprofit Organization - Supporter (see above)
An Individual - MBC Patient or Patient Advocate (See above)
A Pharmaceutical / Biotech Company
Required
Tell us about you...
(Individual applicants may use "Individual" or "N/A" as a response for Job Title and Company Name)

First Name:
Last Name:
Job Title:
Company Name:
Work Phone:
Email Address:
emailaddress@xyz.com
Address 1:
Address 2:
City:
State/Province
(US/Canada):
Postal Code:

Please describe the mission of your organization. 

 

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Website

 

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Blog URL
 

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Facebook Page

 

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Twitter Handle

 

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Briefly describe why you or your organization is interested in becoming a member of the Alliance.

 

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Write a short statement of the actions you or your organization is taking to advance research, information and support services, awareness and education, and policy regarding metastatic breast cancer.

 

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Outline the ways you can contribute to the MBC Alliance, e.g., providing staff time for work groups or promoting the MBC initiatives of other members as well as those of the Alliance.

 

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In which area are you or your organization able to collaborate to meet the goals of the Alliance? Check all that apply.

Furthering research
Improving quality of and access to information and support
Shaping policy
Building awareness of the Alliance's strategic initiatives as well as of MBC in general
Other  
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What percentage (estimated) of your or your organization's work is specific to MBC?

 

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In submitting this application, I/we understand that, as an active member of the MBC Alliance, I or my organization and I:
(i) commit to working collaboratively and cooperatively with other Alliance members,
(ii) will help to promote the work of the Alliance and its member via social media and other networks,
(iii) will contribute resources and assets relating to advancing the efforts of the Alliance; and
(iv) will NOT misrepresent or disparage the Alliance, its members or its activities in any way.

 
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Initial here to acknowledge that you have read and understand the above.

 

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